2024
Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohortSecondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts
Rivier C, Acosta J, Leasure A, Forman R, Sharma R, de Havenon A, Spatz E, Inzucchi S, Kernan W, Falcone G, Sheth K. Secondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts. Journal Of The American Heart Association 2024, 13: e033322. PMID: 38639369, PMCID: PMC11179946, DOI: 10.1161/jaha.123.033322.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsBlood PressureCross-Sectional StudiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedMyocardial InfarctionPlatelet Aggregation InhibitorsPractice Guidelines as TopicRisk AssessmentRisk FactorsSecondary PreventionStrokeUnited KingdomUnited StatesConceptsMyocardial infarctionPrevention scoreSecondary preventionImplementation of preventive therapyNational cohortUK BiobankAntiplatelet therapy useGuideline-directed therapyPrevention profilesBlood pressure controlAdherence to guideline-directed therapyLow-density lipoprotein controlNeighborhood deprivation levelHistory of strokeVascular risk profileStatin useAntiplatelet useTherapy usePreventive therapyComparison to participantsPrevention criteriaCross-sectional analysisBlood pressurePatientsPressure controlImpact of sleep quality and physical activity on blood pressure variability
de Havenon A, Falcone G, Rivier C, Littig L, Petersen N, de Villele P, Prabhakaran S, Kimberly W, Mistry E, Sheth K. Impact of sleep quality and physical activity on blood pressure variability. PLOS ONE 2024, 19: e0301631. PMID: 38625967, PMCID: PMC11020843, DOI: 10.1371/journal.pone.0301631.Peer-Reviewed Original ResearchConceptsSleep qualityPhysical activityOdds ratioCohort of community-dwelling adultsCommunity-dwelling adultsExcess relative riskBlood pressure variabilityExamined sleep qualityPoor sleep qualitySystolic blood pressure standard deviationSleep interruptionBody mass indexPhysical inactivityPrimary study outcomeStep countsImpact of sleep qualityLowest tertileRelative riskHigh blood pressure variabilityHome measurement devicesActivity levelsExposure statusPoor sleepMass indexStudy outcomesAPOE ε4 and Intracerebral Hemorrhage in Patients With Brain Arteriovenous Malformation
Renedo D, Rivier C, Koo A, Sujijantarat N, Clocchiatti-Tuozzo S, Wu K, Torres-Lopez V, Huo S, Gunel M, de Havenon A, Sheth K, Matouk C, Falcone G. APOE ε4 and Intracerebral Hemorrhage in Patients With Brain Arteriovenous Malformation. JAMA Network Open 2024, 7: e2355368. PMID: 38363572, PMCID: PMC10873768, DOI: 10.1001/jamanetworkopen.2023.55368.Peer-Reviewed Original ResearchConceptsApolipoprotein E e4Participants of European ancestryRisk of intracerebral hemorrhageHigh risk of intracerebral hemorrhageCross-sectional studyUK BiobankEuropean ancestryHigh riskUs Research ProgramUK Biobank participantsInternational Classification of DiseasesAssociated with higher risk of ICHCross-sectional study of patientsAPOE e4 statusClassification of DiseasesApolipoprotein ENinth Revision and Tenth RevisionAssociated with higher riskIndividual-level dataMultivariate logistic regressionIntracerebral hemorrhage riskBrain arteriovenous malformationsIntracerebral hemorrhageBiobank participantsTenth RevisionAssociation Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis
Harris W, Kaiser J, Liao V, Avadhani R, Iadecola C, Falcone G, Sheth K, Qureshi A, Goldstein J, Awad I, Hanley D, Kamel H, Ziai W, Murthy S. Association Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis. Stroke 2024, 55: 541-547. PMID: 38299346, PMCID: PMC10932908, DOI: 10.1161/strokeaha.123.045859.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhage volumeMedian ICH volumeRisk of ischemic strokeHematoma volumeIntracerebral hemorrhageIncreased risk of ischemic strokeATACH-2ICH volumeIschemic strokeCumulative incidenceMISTIE IIIIncreased riskLong-term increased riskIntracerebral hemorrhage characteristicsMedian hematoma volumeHeterogeneous cohort of patientsMedian follow-upPrimary analysisIntracerebral hemorrhage locationCohort of patientsNontraumatic intracerebral hemorrhageCox regression analysisShort-term risk of ischemic strokeCox regression modelsIndividual patient data
2023
Suboptimal Sleep Duration Is Associated With Poorer Neuroimaging Brain Health Profiles in Middle‐Aged Individuals Without Stroke or Dementia
Clocchiatti‐Tuozzo S, Rivier C, Renedo D, Lopez V, Geer J, Miner B, Yaggi H, de Havenon A, Payabvash S, Sheth K, Gill T, Falcone G. Suboptimal Sleep Duration Is Associated With Poorer Neuroimaging Brain Health Profiles in Middle‐Aged Individuals Without Stroke or Dementia. Journal Of The American Heart Association 2023, 13: e031514. PMID: 38156552, PMCID: PMC10863828, DOI: 10.1161/jaha.123.031514.Peer-Reviewed Original ResearchConceptsSuboptimal sleep durationWhite matter hyperintensitiesMiddle-aged individualsLong sleep durationLarger WMH volumeSleep durationMiddle-aged adultsHealth profileWMH volumeAmerican Heart Association's LifeAsymptomatic middle-aged adultsWMH presenceVolume of WMHOptimal sleepSelf-reported sleep durationModifiable risk factorsWhite matter tractsProspective magnetic resonanceSimple 7Cardiovascular healthRisk factorsShort sleepMatter hyperintensitiesHigh riskEarly interventionAssociation of Poor Oral Health With Neuroimaging Markers of White Matter Injury in Middle-Aged Participants in the UK Biobank.
Rivier C, Renedo D, de Havenon A, Sunmonu N, Gill T, Payabvash S, Sheth K, Falcone G. Association of Poor Oral Health With Neuroimaging Markers of White Matter Injury in Middle-Aged Participants in the UK Biobank. Neurology 2023, 102: e208010. PMID: 38165331, PMCID: PMC10870735, DOI: 10.1212/wnl.0000000000208010.Peer-Reviewed Original ResearchConceptsPoor oral healthOral healthBrain healthRisk factorsNeuroimaging markerWMH volumeHealth profileMD scoreSelf-reported poor oral healthCross-sectional neuroimaging studiesFractional anisotropyWhite matter hyperintensity volumeModifiable risk factorsWhite matter injuryPresence of denturesMendelian randomizationMiddle-aged personsFA scoreMiddle-aged participantsLoose teethCardiovascular diseaseHyperintensity volumeBrain MRIModifiable processEarly interventionImprovement in the Prediction of Cerebrovascular Events With White Matter Hyperintensity
de Havenon A, Smith E, Sharma R, Falcone G, Bangad A, Prabhakaran S, Sheth K. Improvement in the Prediction of Cerebrovascular Events With White Matter Hyperintensity. Journal Of The American Heart Association 2023, 12: e029374. PMID: 37345754, PMCID: PMC10356061, DOI: 10.1161/jaha.123.029374.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesIncident strokePrimary outcomeHypertensive individualsMatter hyperintensitiesAtherosclerotic cardiovascular disease risk scoreCognitive impairmentCardiovascular disease risk scoreVascular risk factorsCurrent cigarette smokingDisease risk scoreMagnetic resonance imagingLogistic regression modelsRandomization armCerebrovascular eventsVascular riskCigarette smokingPrognostic informationRisk factorsPrognostic abilityRisk scoreCognitive declineResonance imagingDeLong testStrokePolygenic Susceptibility to Hypertension and Cognitive Performance in Middle-aged Persons Without Stroke or Dementia
Rivier C, Szejko N, Renedo D, Noche R, Acosta J, Both C, Sharma R, Torres-Lopez V, Payabvash S, de Havenon A, Sheth K, Gill T, Falcone G. Polygenic Susceptibility to Hypertension and Cognitive Performance in Middle-aged Persons Without Stroke or Dementia. Neurology 2023, 101: e512-e521. PMID: 37295956, PMCID: PMC10401683, DOI: 10.1212/wnl.0000000000207427.Peer-Reviewed Original ResearchIdentification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging
de Havenon A, Parasuram N, Crawford A, Mazurek M, Chavva I, Yadlapalli V, Iglesias J, Rosen M, Falcone G, Payabvash S, Sze G, Sharma R, Schiff S, Safdar B, Wira C, Kimberly W, Sheth K. Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging. Journal Of The American Heart Association 2023, 12: e029242. PMID: 37218590, PMCID: PMC10381997, DOI: 10.1161/jaha.122.029242.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesMagnetic resonance imagingSevere white matter hyperintensitiesConventional magnetic resonance imagingResonance imagingRetrospective cohortEmergency departmentMatter hyperintensitiesVascular risk factorsProspective observational studyVascular cognitive impairmentTesla magnetic resonance imagingArea Deprivation IndexProspective cohortAdult patientsAcute careRisk factorsCardiovascular diseaseObservational studyCognitive impairmentPatientsCare magnetic resonance imagingIntermodality agreementCohortDeprivation indexBlood pressure-related white matter microstructural disintegrity and associated cognitive function impairment in asymptomatic adults
Acosta J, Haider S, Rivier C, Leasure A, Sheth K, Falcone G, Payabvash S. Blood pressure-related white matter microstructural disintegrity and associated cognitive function impairment in asymptomatic adults. Stroke And Vascular Neurology 2023, 8: 358-367. PMID: 36878613, PMCID: PMC10647862, DOI: 10.1136/svn-2022-001929.Peer-Reviewed Original Research
2022
Baseline Serum Biomarkers of Inflammation and Subsequent Visit-to-Visit Blood Pressure Variability: A Post Hoc Analysis of MESA
Wong KH, Muddasani V, Peterson C, Sheibani N, Arkin C, Cheong I, Majersik JJ, Biffi A, Petersen N, Falcone GJ, Sansing LH, de Havenon AH. Baseline Serum Biomarkers of Inflammation and Subsequent Visit-to-Visit Blood Pressure Variability: A Post Hoc Analysis of MESA. American Journal Of Hypertension 2022, 36: 144-147. PMID: 36315490, DOI: 10.1093/ajh/hpac122.Peer-Reviewed Original ResearchMeSH KeywordsAtherosclerosisBiomarkersBlood PressureFemaleHumansHypertensionInflammationInterleukin-6MaleMiddle AgedConceptsBlood pressure variabilityHigh blood pressure variabilitySerum inflammatory markersPlasmin-antiplasmin complexC-reactive proteinInterleukin-6Inflammatory markersBlood pressureStudy visitPressure variabilityBaseline serum IL-6Visit blood pressure variabilityLipid-lowering medicationsMean blood pressureSerum IL-6Markers of inflammationSystolic blood pressureBaseline study visitBody mass indexOnly IL-6Major vascular diseasesMulti-Ethnic StudyBaseline serum biomarkersPatient age categoryPost Hoc AnalysisAssociation of Chronic Kidney Disease With Risk of Intracerebral Hemorrhage
Vanent KN, Leasure AC, Acosta JN, Kuohn LR, Woo D, Murthy SB, Kamel H, Messé SR, Mullen MT, Cohen JB, Cohen DL, Townsend RR, Petersen NH, Sansing LH, Gill TM, Sheth KN, Falcone GJ. Association of Chronic Kidney Disease With Risk of Intracerebral Hemorrhage. JAMA Neurology 2022, 79: 911-918. PMID: 35969388, PMCID: PMC9379821, DOI: 10.1001/jamaneurol.2022.2299.Peer-Reviewed Original ResearchOne-Year Outcome Trajectories and Factors Associated with Functional Recovery Among Survivors of Intracerebral and Intraventricular Hemorrhage With Initial Severe Disability
Shah VA, Thompson RE, Yenokyan G, Acosta JN, Avadhani R, Dlugash R, McBee N, Li Y, Hansen BM, Ullman N, Falcone G, Awad IA, Hanley DF, Ziai WC. One-Year Outcome Trajectories and Factors Associated with Functional Recovery Among Survivors of Intracerebral and Intraventricular Hemorrhage With Initial Severe Disability. JAMA Neurology 2022, 79: 856-868. PMID: 35877105, PMCID: PMC9316056, DOI: 10.1001/jamaneurol.2022.1991.Peer-Reviewed Original ResearchMeSH KeywordsCerebral HemorrhageFemaleHematomaHumansIschemic StrokeMaleMiddle AgedSurvivorsTissue Plasminogen ActivatorConceptsSevere intracerebral hemorrhagePhase 3 trialIntracerebral hemorrhageIntraventricular hemorrhagePoor functional outcomeHospital eventsBetter outcomesDay 30Functional recoveryPoor outcomeFunctional outcomeLong-term functional recoverySevere disabilityMultivariable logistic regression modelHealth Stroke ScaleAcute ischemic strokeCerebral perfusion pressureRankin Scale scoreStandard medical careIndividual patient dataOverall mean ageIntracranial pressure monitoringLogistic regression modelsIntraventricular alteplaseMISTIE IIICarotid Artery Disease Among Broadly Defined Underrepresented Groups: The All of Us Research Program
Renedo D, Acosta JN, Sujijantarat N, Antonios JP, Koo AB, Sheth KN, Matouk CC, Falcone GJ. Carotid Artery Disease Among Broadly Defined Underrepresented Groups: The All of Us Research Program. Stroke 2022, 53: e88-e89. PMID: 35109680, PMCID: PMC8944776, DOI: 10.1161/strokeaha.121.037554.Peer-Reviewed Original ResearchBedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2021
Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage
Mazurek MH, Cahn BA, Yuen MM, Prabhat AM, Chavva IR, Shah JT, Crawford AL, Welch EB, Rothberg J, Sacolick L, Poole M, Wira C, Matouk CC, Ward A, Timario N, Leasure A, Beekman R, Peng TJ, Witsch J, Antonios JP, Falcone GJ, Gobeske KT, Petersen N, Schindler J, Sansing L, Gilmore EJ, Hwang DY, Kim JA, Malhotra A, Sze G, Rosen MS, Kimberly WT, Sheth KN. Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage. Nature Communications 2021, 12: 5119. PMID: 34433813, PMCID: PMC8387402, DOI: 10.1038/s41467-021-25441-6.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingNIH Stroke ScaleIntracerebral hemorrhageHematoma volumeYale-New Haven HospitalStroke care pathwayConventional magnetic resonance imagingBoard-certified neuroradiologistsNew Haven HospitalResource-limited settingsStroke ScaleClinical outcomesLow-field magnetic resonance imagingCare pathwayLow-field magnetic resonanceRadiological examinationConventional neuroimagingAdvanced MRI technologiesResonance imagingCases of disagreementHemorrhageMRI technologyPortable MRINeuroimagingMagnetic resonanceIntracerebral Hemorrhage in Patients With COVID-19
Leasure AC, Khan YM, Iyer R, Elkind MSV, Sansing LH, Falcone GJ, Sheth KN. Intracerebral Hemorrhage in Patients With COVID-19. Stroke 2021, 52: e321-e323. PMID: 34082576, PMCID: PMC8238884, DOI: 10.1161/strokeaha.121.034215.Peer-Reviewed Original ResearchAdolescentAdultAge FactorsAgedAnticoagulantsCerebral HemorrhageCOVID-19C-Reactive ProteinExtracorporeal Membrane OxygenationFemaleHeart Disease Risk FactorsHospital MortalityHospitalizationHumansIntensive Care UnitsInterleukin-6MaleMiddle AgedRegistriesRespiration, ArtificialRisk FactorsSARS-CoV-2Sex FactorsUnited StatesYoung AdultObstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage
Geer JH, Falcone GJ, Vanent KN, Leasure AC, Woo D, Molano JR, Sansing LH, Langefeld CD, Pisani MA, Yaggi HK, Sheth KN. Obstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage. Stroke 2021, 52: 1835-1838. PMID: 33827242, PMCID: PMC8085039, DOI: 10.1161/strokeaha.120.033342.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaRisk factorsBerlin questionnaireIntracerebral hemorrhageSleep apneaEthnic/Racial VariationsHigher body mass indexMultivariable logistic regression modelBody mass indexIntracerebral hemorrhage riskCase-control studyExposure of patientsLogistic regression analysisLogistic regression modelsOSA statusHemorrhage riskMass indexHeart diseaseNontraumatic ICHRacial variationApneaHemorrhageRegression analysisICHRegression modelsAssociation of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage
Leasure AC, Kuohn LR, Vanent KN, Bevers MB, Kimberly WT, Steiner T, Mayer SA, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Association of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage. Stroke 2021, 52: 1733-1740. PMID: 33682454, PMCID: PMC8085132, DOI: 10.1161/strokeaha.120.032888.Peer-Reviewed Original ResearchConceptsIL-6 levelsPerihematomal edema volumeIntracerebral hemorrhageIL-6Edema volumeFunctional outcomeICH locationICH volumeTreatment groupsSerum IL-6 levelsBaseline ICHAcute brain injuryLarge intracerebral hemorrhageSerum IL-6Predictors of outcomeSpontaneous intracerebral hemorrhageRankin ScalePoor outcomeProinflammatory cytokinesTrial populationBrain injurySecondary analysisStrong associationFast trialsOutcomes